Workshop 3: Meningitis & CSF leaks

Question 1

Meningitis: Symptoms

Answer 1

Inflammation of the meninges (around brain and spinal cord), neck stiffness, fever, confusion or altered mental status, headaches, nausea and vomiting. seizures, coma, neurological deficits, sepsis.
Life threatening
- (vary depending on if viral or bacterial, bacterial harder to resolve, viral more common)
1/6 of people with bacterial die, 1/5 experience later complications

Question 2

Meningitis: Test

Answer 2

spinal tap
* Positive result = cloudy CSF

• Glass test if have a rash (if not disappearing, more likely to be meningitis)

Question 3

Meningitis: Causes

Answer 3

Bacterial meningitis rarer but more serious than viral meningitis.

Also caused by fungi and parasitic infections

- There are four main causes of acute bacterial meningitis:
	Neisseria meningitidis (meningococcus)
	Streptococcus pneumoniae (pneumococcus)
	Haemophilus influenzae Streptococcus agalactiae (group B streptococcus)

Transmission:
- They spread from person to person by respiratory droplets or throat secretions. Group B streptococcus is often carried in the human gut or vagina and can spread from mother to child around the time of birth.
Carriage of these organisms is usually harmless and helps build up immunity against infection, but the bacteria occasionally invade the body causing meningitis and sepsis

Question 4

Meningitis: Prevention

Answer 4

Vaccination, antibiotics, social distancing.

(typically do have meningitis bacteria in saliva but manageable mostly)

Question 5

Meningitis: Treatment

Answer 5

Antibiotics, antiviral/fungal medications

Question 6

CSF leaks: Symtoms

Answer 6

Intracranial hypotension (too little tension), postural headache (when stood up, not as buoyant with a leak = pressure on back of brain as less floating), loss of smell, blurred vision, hearing loss, pulsatile tinnitus, seizures, dizziness, neck pain, nausea, vomiting, balance or gait problems, runny nose.

Question 7

CSF Leaks: Test

Answer 7

Test = CT scan, MRI scan, cisternogram (inject radioactive substance in lumbar region of spine, can pick up on where CFS is leaking

Question 8

CSF Leaks: Causes

Answer 8

90% due to injury,

10% spontaneous (Ehlers Danlos and Marfan syndromes, higher risk- links to connective tissue, can be genetic aspects, growths can lead to internal to leaks)

Question 9

CSF Leaks: Prevention

Answer 9

un-preventable and unpredictable

(can look for symptoms in high risk people, e.g. Ehlers Danlos & Marfan syndromes)

Question 10

CSF Leaks: Treatment

Answer 10

Mostly non-direct conservative treatment of rest and time (e.g. lying down can alleviate postural headaches.

In some cases, endoscopic surgery, and ‘blood patches

Question 11

The stiff and painful neck symptoms of meningitis is associated with which process?

Answer 11

Stretching of inflames meninges

Question 12

What percentage of CSF leaks are spontaneous leaks without injury?

Answer 12

10%

Question 13

Most vulnerable to bacterial meningitis?

Answer 13

A new-born baby

Question 14

Where in the world is meningitis most common?

Answer 14

Sub-saharan Africa

Question 15

WHO targets for menigitis?

Answer 15

• elimination of bacterial meningitis epidemics
• Reduction of cases of vaccine-preventable bacterial meningitis by 50% and deaths by 70%
• reduction of disability and improvement of quality of life after meningitis due to any cause

Question 16

Amyotrophic lateral sclerosis (ASL) is usually fatal because…

Answer 16

Respiratory failure

(no cure)